Epithelial Dysplasia and Cancer in IBD Strictures

Amnon Sonnenberg, Robert M. Genta

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

BACKGROUND: Colonic strictures and epithelial dysplasia are both known risk factors for the occurrence of colorectal cancer in inflammatory bowel disease (IBD) patients. The aim of the present work was to study colonic stricture as a risk factor for the occurrence of epithelial dysplasia and colonic adenocarcinoma.

METHODS: In a case-control study among 53568 IBD patients undergoing colonoscopy, we compared the prevalence of strictures among cases with dysplasia or adenocarcinoma and controls without such complications by calculating odds ratios (ORs) and their 95% confidence intervals (CIs). Multivariate logistic regressions were used to assess the joint influence of multiple predictor variables (age, sex, IBD type and stricture) on the occurrence of colonic dysplasia or adenocarcinoma.

RESULTS: The prevalence of strictures was 1.06% in ulcerative colitis (UC) and 8.71% in Crohn's disease (CD, OR 11.09, 95% CI 9.72-12.70). The prevalence of dysplasia was 3.22% in UC and 2.08% in CD (OR 0.75, 95% CI 0.65-0.86). The prevalence of dysplasia was similar in IBD patients with and without stricture: 2.82 and 2.41%, respectively. The prevalence of cancer was higher in IBD patients with than without stricture: 0.78 and 0.11%, respectively (OR 6.87, 95% CI 3.30-12.89). In the multivariate analysis, old age, male sex and UC, but not stricture, were all significantly and independently associated with dysplasia. Old age, dysplasia and stricture were significantly and independently associated with cancer.

CONCLUSION: The prevalence of epithelial dysplasia is not generally increased in IBD patients with strictures.

Original languageEnglish (US)
Pages (from-to)769-775
Number of pages7
JournalJournal of Crohn's and Colitis
Volume9
Issue number9
DOIs
Publication statusPublished - Sep 1 2015

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Keywords

  • Colon cancer
  • dysplasia
  • epidemiology
  • histopathology of inflammatory bowel disease
  • intestinal strictures

ASJC Scopus subject areas

  • Medicine(all)

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